John L. Marshall, MD


March 30, 2015

Editorial Collaboration

Medscape &

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Editor's Note: What do physicians think about Cancer: The Emperor of All Maladies, currently airing on PBS? Join our live chat and find out. Medscape will be hosting a live chat on March 30, March 31, and April 1, from 11 AM until 11:30 PM EDT. In this forum, readers are invited to respond to the documentary and the issues it raises about the future of cancer care. Stop by and contribute to the conversation.

This is John Marshall for Medscape. A few days from now (on March 30), public television is going to begin airing the WETA series Cancer: The Emperor of All Maladies. Most of you have already read the book on which this is based. It's a great book. It teaches us about the history of our profession—of oncology—and it has now been turned into a 6-hour, three-part film by Ken Burns that tells the history and science behind cancer and cancer medicine. It shows patients and patients' families, good and bad outcomes.

I was lucky enough last week to be invited to a local event where we were able to preview 1 hour of this program. I was sitting next to my wife, who is a cancer survivor, and next to other colon cancer survivors who are friends. I wasn't expecting the emotion that came out when they watched this video. Just the shot of an intravenous pole was so striking to them that it caused them to tear up. Watching a patient receive a diagnosis caused these experienced cancer veterans to become very anxious and upset. They remembered all that they had felt when it happened to them.

I have warned our division. I want to warn you all that on Tuesday morning, our patients are going to come in, and those who watched this film are going to experience a lot of emotion. We need to be ready to deal with it.

There will be a lot of emotion and feedback for us because the film is a microscopic look, a deep dive into our profession and what we do. There is a lot of high praise for oncologists in the cancer care community, but at the same time it shows what we do day in and day out. We are going to feel proud and vulnerable at the same time. I want you to note that and be ready for it.

We are excited. It's going to be a great time. We are going to see a wave of awareness on all fronts about cancer and cancer medicine, how cancer is a terrible set of diseases, how we are making progress, how we have far to go, how research is part of the answer, how there is not enough funding for it, and how the all of the system is not set up to drive forward and actually cure cancers as we are trying to do here at the Ruesch Center for the Cure of Gastrointestinal Cancers.

This is an opportunity for us as this wave of positive sentiment comes forward. We need to ensure that we press for more research funding and more participation in clinical research—and we press each other to do the best, day in and day out, that we can for our patients, to look at the evidence that we have and move it forward, to look at our mistakes from behind and look forward to better and brighter futures. If we don't ride this wave, build on it and grow it and keep the momentum going, it will be an opportunity lost.

I have two points: Be ready for the wave of emotion that you are going to feel as you watch this film and as our patients and former patients watch it. But also be prepared for the wave of understanding that people are going to have as they watch it. Those from outside the cancer community will see the needs that are there, and the science that is there. We need to put the two together to drive forward and make significant strides in the world of metastatic cancers, and cancers in general.

Watch it. I think you will be moved. We will talk about the pre-Emperor and the post-Emperor time frame in terms of public awareness around cancer and cancer care. I know that I'm going to be glued to the television.


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